Spectrum of tardive syndromes: clinical recognition and management
Identifieur interne : 001981 ( Istex/Checkpoint ); précédent : 001980; suivant : 001982Spectrum of tardive syndromes: clinical recognition and management
Auteurs : Roongroj Bhidayasiri [Thaïlande, États-Unis] ; Suthida Boonyawairoj [Thaïlande]Source :
- Postgraduate Medical Journal [ 0032-5473 ] ; 2011-02.
Descripteurs français
- Wicri :
- topic : Psychiatrie.
English descriptors
- KwdEn :
- Abnormal movements, Abnormality, Akathisia, Antipsychotic, Atypical, Atypical antipsychotics, Atypical neuroleptics, Botulinum, Botulinum toxin, Brain stimulation, Classical tardive dyskinesia, Clin, Clozapine, Differential diagnosis, Discontinuation, Disord, Dopamine, Drbas, Dyskinesia, Dystonia, Dystonic, Extrapyramidal, Idiopathic, Involuntary movements, Jankovic, Movement disorders, Myoclonus, Neuroleptic, Neuroleptic exposure, Neuroleptic therapy, Neuroleptic treatment, Parkinsonism, Postgrad, Psychiatry, Psychopharmacol, Receptor, Risk factors, Risperidone, Schizophrenia, Stereotypy, Suppressive, Suppressive agents, Syndrome, Tardive, Tardive akathisia, Tardive dyskinesia, Tardive dystonia, Tardive syndromes, Tic, Toxin, Tremor, Typical neuroleptics.
- Teeft :
- Abnormal movements, Abnormality, Akathisia, Antipsychotic, Atypical, Atypical antipsychotics, Atypical neuroleptics, Botulinum, Botulinum toxin, Brain stimulation, Classical tardive dyskinesia, Clin, Clozapine, Differential diagnosis, Discontinuation, Disord, Dopamine, Drbas, Dyskinesia, Dystonia, Dystonic, Extrapyramidal, Idiopathic, Involuntary movements, Jankovic, Movement disorders, Myoclonus, Neuroleptic, Neuroleptic exposure, Neuroleptic therapy, Neuroleptic treatment, Parkinsonism, Postgrad, Psychiatry, Psychopharmacol, Receptor, Risk factors, Risperidone, Schizophrenia, Stereotypy, Suppressive, Suppressive agents, Syndrome, Tardive, Tardive akathisia, Tardive dyskinesia, Tardive dystonia, Tardive syndromes, Tic, Toxin, Tremor, Typical neuroleptics.
Abstract
Tardive syndrome (TS) refers to a group of delayed onset disorders characterised by abnormal movements and caused by dopamine receptor blocking agents (DRBAs). Classical tardive dyskinesia is a specific type of oro-buccal-lingual dyskinesia. However, TS may exist in other forms—for example, stereotypy, dystonia, and akathisia—and frequently occur in combination. The onset typically is insidious and after reaching its maximum severity it often stabilises. Frequently reported risk factors are age, dose and duration of neuroleptic exposure, the use of conventional DRBAs, and co-existing mood disorders. This review highlights the broad spectrum of TS, not limited to classical tardive dyskinesia, as well as the clues for its recognition. Despite challenges in the treatment of TS, dictated by the different phenomenology, severity of TS and the need for ongoing neuroleptic treatment, the authors provide evidence based recommendations for patient management, which is not restricted to only withdrawal of the offending neuroleptics or the selection of an alternative medication, such as clozapine. In a minority of cases with significant functional disability, symptomatic or suppressive treatments should be considered. Recently, there has been a resurgence of stereotactic pallidal surgery for the treatment of TS. Although the efficacy of both pallidotomy and pallidal deep brain stimulation in dystonia has been encouraging, the evidence is still limited.
Url:
DOI: 10.1136/pgmj.2010.103234
Affiliations:
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ISTEX:CE3205DAA784C0E4DBA0B20F23C882CF153BFE65Le document en format XML
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<term>Atypical antipsychotics</term>
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<front><div type="abstract">Tardive syndrome (TS) refers to a group of delayed onset disorders characterised by abnormal movements and caused by dopamine receptor blocking agents (DRBAs). Classical tardive dyskinesia is a specific type of oro-buccal-lingual dyskinesia. However, TS may exist in other forms—for example, stereotypy, dystonia, and akathisia—and frequently occur in combination. The onset typically is insidious and after reaching its maximum severity it often stabilises. Frequently reported risk factors are age, dose and duration of neuroleptic exposure, the use of conventional DRBAs, and co-existing mood disorders. This review highlights the broad spectrum of TS, not limited to classical tardive dyskinesia, as well as the clues for its recognition. Despite challenges in the treatment of TS, dictated by the different phenomenology, severity of TS and the need for ongoing neuroleptic treatment, the authors provide evidence based recommendations for patient management, which is not restricted to only withdrawal of the offending neuroleptics or the selection of an alternative medication, such as clozapine. In a minority of cases with significant functional disability, symptomatic or suppressive treatments should be considered. Recently, there has been a resurgence of stereotactic pallidal surgery for the treatment of TS. Although the efficacy of both pallidotomy and pallidal deep brain stimulation in dystonia has been encouraging, the evidence is still limited.</div>
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